Taking Advantage of New EFT & ERA Mandates: Providers - Contact Your Health Plans

Taking Advantage of New EFT & ERA Mandates: Providers - Contact Your Health Plans Are you or do you know a provider organization that would benefit from transitioning to electronic payments? CAQH CORE is pleased to announce the release of a new tool to assist providers that want to transition from paper checks to electronic funds transfer (EFT) payments: a Sample Provider EFT Request Letter a provider can email to health plans or use as talking points for a phone call with health plan contacts to request payment via EFT, as well as EFT & ERA Operating Rule implementation status. The Affordable Care Act (ACA) requires that as of January 1, 2014 all HIPAA covered health plans must offer to providers an electronic payment option via the newly mandated Healthcare EFT Standard (i.e., NACHA CCD+). Thus, by this date, providers are encouraged to request EFT payment from health plans. There are many reasons providers should consider transitioning to EFT payments, including: Faster payment and remittance advice processing Reductions in phone calls to health plans Time savings associated with manual processes such as sorting mail, opening envelopes, posting the checks, depositing the checks, and ultimately reconciling the paper remittance advice with the patient accounts Lower risk of lost or stolen checks Furthermore, the ACA-mandated EFT & ERA Operating Rules support more efficient provider use of both EFT payments and ERAs. The rules address market needs such as more standardized, electronic provider enrollment in EFT and ERA and easier reassociation of EFTs and ERAs. As of January 1, 2014, health plans must have a process in place to offer the benefits of the mandated Operating Rules to providers. Therefore, CAQH CORE has developed this sample letter for providers wishing to enroll in EFT payments and receive an update on a health plan's EFT & ERA Operating Rule implementation. This new tool complements the existing Sample Provider EFT Reassociation Data Request Letter, which providers may use to contact their financial institution(s) regarding EFT.